Patient awareness, perception and attitude to contrast-enhanced CT examination: Implications for communication and compliance with patients' preferences

Adv Clin Exp Med. 2019 Jul;28(7):923-929. doi: 10.17219/acem/94146.

Abstract

Background: Despite the high volume of contrast-enhanced computed tomography (CECT) examinations, there is limited awareness about its risks among patients and little is known about the influence of patient information sheets.

Objectives: The objective of this study was to assess patients' awareness and perception of risks related to CECT examination and how they are influenced by an information sheet.

Material and methods: A total of 263 adult patients scheduled for a CECT examination completed a questionnaire. The first page evaluated patients' characteristics, their fear and awareness about examination-related risks, and source of information. Page 2 contained the Zung self-rating anxiety scale. After reading the information sheet, patients completed page 3 that surveyed how their awareness and fear had changed.

Results: Nearly half of the patients underestimated the risk of secondary malignancy (n = 121, 46%), or the risk of renal impairment (n = 110, 42%). The vast majority (n = 227, 86%) stated that they were not instructed to maintain fluid intake up to 1 h before the procedure. After reading the information sheet, patients generally corrected their knowledge, but 195 (74%) reported experiencing greater fear (p < 0.0001). Fear was more pronounced in younger female patients who had not undergone CT previously. Patients feared the result more than examination-related risks. Most patients (n = 204, 78%) would feel uncomfortable before receiving the examination result.

Conclusions: Most patients do not assess risks related to CECT examination correctly. Although the information sheet improves patients' understanding of CECT-related risks, it lacks empathically delivered reassurance and increases their fear. Fast communication of examination results would make patients feel more comfortable.

Keywords: multidetector computed tomography; patient education; patient preference; radiation exposure; test anxiety scale.

MeSH terms

  • Adult
  • Aged
  • Awareness
  • Communication*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Middle Aged
  • Multidetector Computed Tomography / adverse effects*
  • Multidetector Computed Tomography / methods
  • Patient Compliance*
  • Patient Education as Topic
  • Patient Preference*
  • Radiation Exposure
  • Surveys and Questionnaires